2022 World Conference on Lung Cancer (ePosters)-EP16.01-002. T Cell Receptor Diversity among Non-Small Cell Lung Cancer Patients Treated with Pembrolizumab Alone or in Combination with Chemotherapy

EP16.01-002. T Cell Receptor Diversity among Non-Small Cell Lung Cancer Patients Treated with Pembrolizumab Alone or in Combination with Chemotherapy

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A recent study aimed to explore the correlation between pre-treatment T-cell receptor (TCR) repertoire and clinical outcomes in non-small cell lung cancer (NSCLC) patients treated with pembrolizumab alone or in combination with chemotherapy. The study included 128 patients with locally advanced or metastatic NSCLC who were treated with pembrolizumab as a single agent or in combination with chemotherapy. High-quality DNA was extracted from white blood cells, and TCR sequencing was performed using the Oncomine TCR Beta-SR Assay kit.<br /><br />The researchers identified several variables, including age, sex, ECOG performance status, smoking status, disease stage, histopathology, tissue PD-L1 expression, and pre-treatment neutrophil-to-lymphocyte ratio (NLR). The outcomes of interest were overall survival (OS), progression-free survival (PFS), and clinical benefit rate (CBR).<br /><br />In cohort 1, none of the TCR variables were correlated with a statistically significant improvement in OS. In cohort 2, only a high pre-treatment number of unique clones and low TCR evenness were associated with improved overall survival.<br /><br />In terms of PFS, in cohort 1, none of the TCR variables were associated with a statistically significant improvement. However, in cohort 2, patients with a high pre-treatment number of unique clones, low TCR evenness, high TCR Shannon Diversity, and low TCR convergence were more likely to have better PFS.<br /><br />Regarding CBR, in cohort 1, the median number of unique clones was significantly lower among responders compared to non-responders. In cohort 1, patients with a low number of unique clones were more likely to respond to pembrolizumab than those with a high number of unique clones. However, in cohort 2, there was no correlation between response and any of the TCR variables.<br /><br />The study suggests that the pre-treatment TCR repertoire may serve as a predictive biomarker for clinical outcomes in NSCLC patients treated with pembrolizumab alone or in combination with chemotherapy. Further investigations with larger prospective cohorts are needed to validate these findings and determine if the pre-treatment TCR repertoire is a prognostic factor for immunotherapy response.

Asset Subtitle

Afaf Abed

Meta Tag

Speaker Afaf Abed

Topic Tumour Biology and Biomarkers - Immune Biology & Immunotherapy

Keywords

TCR repertoire

clinical outcomes

NSCLC

pembrolizumab

chemotherapy

DNA sequencing

overall survival

progression-free survival

unique clones

response rate